The role of CT-assessed sarcopenia and visceral adipose tissue in predicting long-term survival in patients undergoing elective endovascular infrarenal aortic repair.

OBJECTIVES:To evaluate if ileo-psoas muscle size and visceral adipose tissue can predict long-term survival after EVAR. METHODS:Patients who underwent EVAR between 2004 and 2012 in a single center were included. Total psoas muscle area (TPA), abdominal visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) were measured on the pre-operative CT. Primary endpoint was all-cause mortality. Values are presented as median and interquartile range or absolute number and percentage. Cox regression analyses were performed to assess the associations with mortality. RESULTS:Two hundred eighty-four patients could be included in the study. During a median follow-up of 8 (4-11) years, 223 (79.9%) patients died. Age (P = < .001), cardiovascular (P = .041), cerebrovascular (P = .009), renal diseases (P = .002) and COPD (P = < .001) were independently associated with mortality. TPA was associated with mortality in a univariate (P = .040), but not in a multivariate regression model (P = .764). No significant association was found between mortality and TPA index (P = .103) or any of the adiposity measurements with the exception of SAT (P = .040). However, SAT area loss in a multivariate analysis (P = .875). CONCLUSIONS:assessment of core muscle size and visceral adipose tissue did not contribute to improving the prediction of long-term survival after EVAR. ADVANCES IN KNOWLEDGE:The finding of this study contradicts the previously claimed utility of core muscle size and visceral adipose tissue in predicting long-term survival after EVAR.